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脱套与复位——孤立性阴茎扭转的简单修复

Degloving and realignment--simple repair of isolated penile torsion.

作者信息

Bar-Yosef Yuval, Binyamini Joseph, Matzkin Haim, Ben-Chaim Jacob

机构信息

Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.

出版信息

Urology. 2007 Feb;69(2):369-71. doi: 10.1016/j.urology.2007.01.014.

Abstract

OBJECTIVES

To present the results of repairing congenital or acquired penile torsion by means of a simple surgical procedure that does not involve resection of corporeal tissue.

METHODS

Forty-six circumcised patients (mean age 27 months, range 6 to 119) presented with isolated penile torsion of a greater than 30 degree rotation. The surgical technique involved degloving the penile skin to the penoscrotal junction. Residual torsion was corrected using 5-6/0 polyglactin absorbable suture applied to the desired 12-o'clock position of the penile skin adjacent to the glans and to a location counter to the direction of the torsion in the degloved penile skin sleeve. A wedge of loose ventral penile skin was usually resected. The resultant tightening of the skin allowed for proper alignment of the penis and better cosmesis. The rest of the circumferential incision was closed using the same suture material. The success of the procedure was evaluated according to physician and parental satisfaction with the final outcome.

RESULTS

Thirty-seven patients were available for follow-up (mean 31 months, range 8 to 68). Satisfactory results were achieved in 35 (95%) of the 37 patients; the other 2 had residual torsion. Complications were minor and consisted of postoperative fever and a subcutaneous hematoma in 1 patient that resolved with conservative treatment.

CONCLUSIONS

The degloving and realignment procedure is a simple technique that may be applied safely and successfully in most cases of penile torsion.

摘要

目的

介绍一种不涉及阴茎体组织切除的简单手术方法修复先天性或后天性阴茎扭转的结果。

方法

46例接受包皮环切术的患者(平均年龄27个月,范围6至119个月),表现为孤立性阴茎扭转超过30度。手术技术包括将阴茎皮肤脱套至阴茎阴囊交界处。使用5-0或6-0聚乙醇酸可吸收缝线,在龟头附近阴茎皮肤所需的12点位置以及脱套阴茎皮肤袖套中与扭转方向相反的位置,矫正残余扭转。通常切除一块阴茎腹侧松弛的皮肤楔形组织。由此产生的皮肤收紧可使阴茎正确对齐并改善美观。环形切口的其余部分使用相同的缝合材料缝合。根据医生和家长对最终结果的满意度评估手术的成功率。

结果

37例患者可供随访(平均31个月,范围8至68个月)。37例患者中的35例(95%)取得了满意的结果;另外2例有残余扭转。并发症轻微,1例患者出现术后发热和皮下血肿,经保守治疗后痊愈。

结论

脱套和重新对齐手术是一种简单的技术,在大多数阴茎扭转病例中可以安全、成功地应用。

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